Alla Kos in Minsk
Nearly a decade and a half after the world's worst nuclear disaster, millions of people in the three affected countries - Belarus, Russia and Ukraine - continue to live in the shadow of radioactive contamination. These people are still suffering from the Chernobyl's greatest long-term health impact: psychological traumas.
People are suffering from anxiety and depression aggravated by the communities' lack of confidence in their future. Chernobyl is an ongoing human drama. Displacement and economic difficulties make life unbearable for the resettled population and especially for lonely elderly.
"When speaking about Chernobyl and the worsening health situation of the population, one should not consider the radiological factor alone. Other things should be also seriously considered. First of all, stress and confusion related to the forced evacuation - whole communities had to leave forever their native places, where they had spent their lives and where they had to leave behind the graves of their loved ones. Second, after the accident the lives of the people were limited by a series of restrictions - they couldn't walk in the forests, swim in the lakes or pick mushrooms and wild berries. Third, people simply didn't know anything about radiation and didn't understand the danger. They were very scared and confused. So, this added greatly to the stress and shock and influenced badly their health ", says Vladimir Masyakin, Chief of the Mobile Units of the Gomel regional specialised dispensary (Radiation Medicine Centre).
"The psychological traumas may not be as evident as the physical destruction of people's homes. However, the recovery from them often takes far longer. The emotional damage to people is a terrible thing and it is really diminishing the quality of life", he adds.
In 1997, the Red Cross initiated a psycho-social project in Belarus in the framework of the Federation's Chernobyl Humanitarian Assistance and Rehabilitation Programme. It was extended to include Ukraine in 1998 and to Bryansk Oblast, one of the worst affected areas in the Russian Federation in 1999. The psycho-social support project was intended primarily for people with severe emotional disturbances caused by a crisis situation like detection of severe thyroid gland pathologies, including cancer. It is designed to help people resolve their anxieties and thereby restore their ability to take control of their lives again. "The activities to develop the population's ability to cope with a crisis situation and stress management include education and training of the Red Cross mobile teams and of the Red Cross volunteers to enable them to give psychological support to the most vulnerable as well as training of the affected population in self-help techniques to manage stress," explains Slava Otchick, co-ordinator of the Chernobyl Humanitarian Assistance and Rehabilitation Programme.
"An important part of the psycho-social support consists in providing information and adequate training for the affected population through lectures, newspaper articles, radio and TV interviews. Clear, simple and reliable information on radiation and stress-related illness reduces anxiety caused by a lack of knowledge," he continues.
So far, nearly 250 Red Cross workers and volunteers have been trained in counselling skills and have provided psychological support to about 15,000 people. About 8,000 local people have attended general information sessions. Some are counselled by telephone and many more are reached through the mass media. Usually, the psychological support is provided by local Red Cross staff and volunteers at medico-social centres, at sites where the Red Cross Mobile Diagnostic Laboratories are situated or at people's homes.
The Red Cross Mobile Diagnostic Laboratories (MDL) are doing psycho-social counselling, along with a medical screening, helping people in remote communities to overcome their fears and restore their coping mechanisms. "People often come full of anxiety and tension. We are doing our best to help them and reduce the impact of these negative feelings. When people are told that they have thyroid nodules and referred for further
examinations, they are very scared of developing cancer - a natural human reaction. Fear for their health and for the future of their children is one of the most acute psychological problems in adult population. By explaining what will happen, by listening carefully to their problems and showing empathy, we help to relieve their pain." says Andrei Fitzura, endocrinologist of the Mogilev MDL.
"During our field trips to the affected areas we always try to give both practical medical advice as well as psychological support. We know that people in the rural areas are waiting for us and come to us willingly to share their concerns with us. Psycho-social support along with the medical screening can make all the difference to these people with no hope, as they often feel that they are forgotten and abandoned and have no bright spots in their lives," Andrei Fitzura adds.
Unlike many humanitarian projects, psychological support is not about relief distributions. Yet, it brings relief to the soul and mind. "The key issues in psychological support are interaction and the fact of being present - to create a feeling of security and hope. Support is not only based on material things or on implementing certain techniques, but also based on our relations to other human beings and our genuine interest in their problems. We can be supportive to others in handling their emotional chaos by ordinary actions - just by being good listeners and let them know that they are not alone", says Nina Bykova, chairperson of the Belarus Red Cross Mogilev regional branch.
"Psychological aid is the kind of support everyone can provide to others in critical life situations by using your own capacities and resources. In simple words, psychological support is about realising what you can do as a person and in this way contribute to make another person feel better. Besides, psychological support is a medicine you can't overdose," underlines Galina Sosnovskaya, a medical psychologist working at the Belarus Red Cross medico-social centre in Shabani, Chernobyl-evacuee district outside Minsk.
During meetings with the beneficiaries Red Cross workers and volunteers encourage them to express their emotions, share thoughts and make decisions in order to solve their problems. Active listening and emotional support are the main tools which the helpers use either on a person-to-person basis or by organizing group meetings. "Resettlers from Chernobyl's contaminated villages often feel rootless and useless in the alien environment of a city. Sometimes they simply need to talk to someone. These groups meetings allow people to share their experiences and break their loneliness and deep depression. The trauma of evacuation has been extremely difficult for many of the old people. Sometimes they return to live in the highly contaminated areas and people call them "self-settlers". So, being with others has a healing effect because isolation and stress will make these people's lives unbearable" says Margarita Shijka,, a Red Cross visiting nurse working at the medico-social centre in Mogilev city.
As part of the Appeal 2001 the International Federation is seeking 1,486,967 CHF to continue providing medical screening and psycho-social support through six Mobile Diagnostic Laboratories.
The psychological support is also being integrated into other programmes. In 2000, vulnerable members of the population were supported with psycho-social assistance by trained staff within the winter emergency operation and via the Visiting Nurses Service, TB and HIV/AIDS programmes. The ultimate goal of the project is to promote health and decrease social tension among the population.
The visibility of the Chernobyl disaster is getting lower and lower compared to all the more recent humanitarian emergencies occurring in the world. Mental health needs in the affected communities remain largely to be addressed and require adequate response. "Psychological aid is a powerful tool. Many of the unfortunate human costs of disasters and health crises can be avoided with appropriate and timely psychological support," says Karen Hvid, Danish health delegate working in the Minsk Delegation for the ECHO-funded Tuberculosis/Visiting Nurses programme.